DPC-participating hospitals are required to create, retain and present files in the style specified by the Ministry of Health, Labor and Welfare (D, E, F files) for subsequent investigation. On the other hand, these files have a very useful data structure for evaluating hospitalization and medical status. In order to devise a new system for the calculation of medical profit in each clinical division and diagnosis-procedure group, these files and medical-affairs accounting systems were combined. Financial analysis of the hospital before and after introducing DPC and new management indexes of the hospital are important for good hospital management. Then we tried to devise a new hospital income analysis system using commercial software's; Excel (Microsoft Corp.) and File Maker (File Maker Inc). In order to check the accuracy and usefulness of the system, we analyzed medical profession profit of the hospital in two years, before and after introducing DPC by the system. Subsequently, the management data individually calculated till then by hospital office work by each specialty and the data outputted from the system were compared. The index for getting to know the present condition of a hospital was also extracted from styles D and E and F file. As a result, it was proved that the system is reliable and can be use enough.

View full abstract

 Patient Classification System is a public information infrastructure for standardized collection of clinical information, and its coding rules are officially maintained and disseminated by public sectors in many developed countries, except for Japan. Lack of publicly available standardized rules may seriously threaten the validity of coding results. In the present study, we originally developed and released a Diagnosis Procedure Combination (DPC) coding program for an open resource use in common to improve the standardization and accuracy of coding procedures. In detail, our developed program automatically produced DPC codes based on selective information in FF1, E and F files. Empirical tests confirmed that the developed program successfully created coding results compatible to those as originally submitted in the D file, at a practically acceptable speed. We further argued the necessity of a legislative framework for standardization of coding logic and compliance of grouper software developers to the standards in this country.

View full abstract

 In recent years, many medical incidents and accidents in hospitals are being reported and to introduce a policy which prevents these accidents is an urgent issue. In this article, we propose a modeling method which utilizes the caring data of nurses monitored by ubiquitous sensors. Our model is based on an analysis of voice records, video records, place data detected by infrared ray sensors, and motion data detected by acceleration sensors. We introduce a hierarchical nursing workflow model to describe a prepared nursing manual and implement a workflow detecting system. By this system, we can interpret and understand the monitored data as actual caring motion of nurses.

View full abstract

 In April 2008, Japan started a nation-wide program of health checks and guidance (HC&G) targeting metabolic syndromes. All personal data related to HC&G are required to be transmitted electronically in XML format to insurers, which maintain a database to keep track of the health status of their enrollees aged 40-74 years. On the other hand, health insurance claims (HICs) from providers, majority of which are still submitted to insurers in paper form will be required to be transmitted electronically by April 2011. The government will be authorized to collect HC&G and HICs data from all insurers and it is foreseen that there will be a national database for improvement of quality of health care. Electronic transmission of HC&G and HIC data are likely to provide an IT infrastructure to serve as a precursor of regional health information networks connecting providers and insurers via information network. Such networks will enable insurers to provide effective disease management programs for a variety of chronic diseases and contribute to long-term health care cost saving. In this article, the author describes technological aspects of the HC&G and HIC data transmission system and its future potential to develop into regional health information networks integrating insurers and providers.

View full abstract

[in Japanese]

View full abstract